DSMES - Diabetes Self-Management Education and Support

Overview

Diabetes is a chronic disease that requires daily self-management decisions and sometimes complex care activities. Diabetes Self-Management Education and Support (DSMES) provides tools to help patients work through these decisions with an overall goal to improve health outcomes. Specifically, DSMES is the process by which coaches facilitate knowledge, skills, and abilities necessary for self-care. By empowering patients through behavior and lifestyle change, the sessions are intended to support self-management on a continual and consistent manner.

There is no one single standard for the provision of diabetes education but both of the highlighted pathways to accreditation follow seven core self-management behaviors, which are:

Health care professionals should look for educational programs that are effective in educational strategies. Standards are used in the field for recognition and accreditation of programs, but there are diabetes self management education programs that are non-accredited and providers that are non-recognized.

By making these seven behavior changes, the participant will have a greater chance of controlling their diabetes. During the education course participants are taught how to problem solve and make informed decisions, while reinforcing self-care. After the course is completed the participant will be able to play an active role in their management of this disease.

Accreditation

There are two organizations that accredit DSME programs:

American Association of Diabetes Educators (AADE) and American Diabetes Association (ADA).

The core components are the same for both organizations, with both requiring their programs to meet ten standards. Renewal is on a regular cycle, and pricing is very similar. Both programs do audits to ensure standards are being met. A Continuous Quality Improvement (CQI) plan must be developed and submitted for both in the initial and renewal applications.

An overview between the two programs is outlined in the table below.

AADE

ADA

Title

Diabetes Education Accreditation Program (DEAP)

Education Recognition Program (ERP)

Guiding Standard

National Standards for DSME

National Standards for DSME

Cost

First site: $1100

Community sites: Free up to 10

Branch locations: $100/additional up to 30 Same fee structure for renewal

First site: $1,100

Additional sites: $100 each

Programs may add unlimited expansion sites for no additional fee. Same fee structure for renewal

Initial Application Process

Online application

Online application

Renewal Application

Same process as initial application and random onsite audit for some sites

Same process as initial application and supporting documentation (proof of CE, licensure, etc.)

Renewal Time Period

Every Four Years

Every Four Years

Why Get Accredited

Accrediting a pharmacy through AADE or ADA allows for alternative reimbursement models and expansion of clinical services in community care. Medicare began reimbursing for DSMES in 1997. Accredited DSMES programs are eligible for Medicare reimbursement and the pharmacy may bill CMS for DSME if the entity (pharmacy) is a Part B provider (pharmacists may not bill as an individual provider).

Pharmacies are uniquely positioned in that payers seeking quality care may refer patients to an accredited center and will reimburse that provider for services. Accreditation allows pharmacists the opportunity to improve chronic disease care by impacting patient health outcomes. Each accrediting organization requires the use of an approved curriculum, allowing the pharmacy team the opportunity to track clinical health markers and patient satisfaction with their clinical services.

Steps to Accreditation

Please know that the two pathways are very similar. However, for PPA's Initiative, PPA's coaching and mentoring program will directly utilize and follow the AADE program only. However, pharmacies can elect to use the ADA program and adapt the work accordingly.

Also pharmacies who may not have been initially approved for the pilot group of pharmacies going through the program, may a join the efforts at their own expense but still receive some of the mentoring and coaching benefits helping you get to filing for accreditation status and offering your program!

Learn more about each program by clicking on the link!

Be sure to select the AADE link to specifically walk through PPA's program.